So long and thanks for all the fish

For anyone who’s paid any attention whatsoever to expert opinion on the issue, the Australia 21 report on illicit drug policy is profoundly unsurprising. As Ben Eltham notes, the evidence is as compelling, if not more, than on climate change. Prohibition has failed, and imposes massive human and financial costs on all of us.

“I think it’s more important that we concentrate as much effort and resource as we possibly can in relation to the policing and enforcement of it, although I appreciate there are criticisms about that approach.”

The imperviousness to expert opinion and painstakingly collected evidence should be an embarrassment to political conservatives – or, perhaps more accurately, the contemporary political right, whose connection with ‘conservatism’ is increasingly tenuous. But the fact that most of the political right is implacably opposed to reforming drug policy is the unpalatable reality. Furthermore, some members of the ALP genuinely share this view; others fear the electoral consequences of anything that could be painted by their political opponents as going “soft on drugs”.

Underlying this is the belief, repeatedly if briefly alluded to in the report, that the electoral consequences of a more rational drugs policy are likely to be severe, largely based on the fears of parents that a less punitive approach will encourage their children to partake.

The challenge for the advocates of sensible drugs policy is now political. The evidence is clear – but how do they get to a better policy given the implacable opposition of the likes of Peter Ryan, and the fear factor in sections of the community?

The arguments surrounding harm reduction are not new, and to date they have failed to achieve the goal of shifting policy. The evidence, sadly, isn’t enough. What’s required is a new way to frame the argument in terms that overcomes the fear of the wavering parents, to the point where Labor feels comfortable enough to pursue reform, because we’re clearly not going to get anything resembling sane drug policy from the right.

What that reframing is, I don’t know. My somewhat cynical guess is that anything that involves the well-being of addicts themselves will fall on deaf ears out in the waverer community. But what the winning message actually is, I don’t know.

But I’m pretty confident that the current presentation of the arguments won’t work, however compelling it is to anybody who looks at the issue in any depth.

145 responses to “Framing the drug law debate”

Well, I reckon its silly criminalizing kids for smoking pot. However, I gather hydroponic grass can cause mental illess. That’s a bit of a worry. So maybe they should legalise bush grass and hash cookies.
And if one has to deal with smack addicts over an extended period of time, believe me its a really unpleasant experience. Worse, though, is coming home and finding your house robbed or them early dead. Not nice.
So I’m a bit ambivalent on that one.

“And if one has to deal with smack addicts over an extended period of time, believe me its a really unpleasant experience. Worse, though, is coming home and finding your house robbed or them early dead. Not nice.
So I’m a bit ambivalent on that one.”

Legalisation removes the need to rob and steal if addicts can get their drugs on prescription.

Is there any research that links ‘harm minimisation’ drug policies to a decrease in property crime and muggings? If treating addicts as having health problems makes them less likely to steal your smartphone – that may shift people’s opinions somewhat (oops – looking for ‘evidence’ again).

As a bleeding heart leftie my views on the immediate problem of how best to deal with the addicts and the problems caused for them and by them has a simple solution.

Decriminialising drugs would make it easier for addicts to get treatment. It would starve crime syndicates of funds. It would reduce police load so they can deal with real crime. It would lower drug related crime.

But there is a massive problem with all the unintended consequences that would flow on from that. Off the top of my head I can think of the following

-Who would manufacture and sell the drugs? Private industry or the government?

-Given that either of the above entities would be selling or providing a product that is in the long term harmful how would we deal with legal liability?

-If we were to write off legal liability (you buy the prescription you take the consequences) would this then not lead to legal challenges by other industries like big tobacco? If government sponsered smack is free from liability then why wouldn’t tobacco be?

-How do we deal with first time users? If we don’t sell to first time users period what sort of other issues are we creating? Would crime syndicates manufacture and sell drugs to unregistered users? Or is it more likley that they would get the drugs directly through registered users either by money, intimidation or force?

-How do we deal with blowback from other countries? Our closest neighbours have hardline drug policies. How will they deal with having a large country at their southern borders as a vector for smuggling drugs into their country?

-How will the US react given their hardline stance? Would we face trade embargos? Banning or extra screening of Australian citizens?

I think the science is fairly conclusive that for a small number of pre-disposed people, cannabinoids (found in all sorts of pot, not just hydro gear) can trigger a psychotic episode. And cannabinoids do quite bad things to the developing adolescent brain. So speaking as someone who may have perhaps once or twice inhaled, I’m not hypocritical in planning on being very prohibitionist with my children as they get older.

So any decriminalisation would have to be very very careful to make sure that susceptible groups did not increase their usage of what has shown to be a harmful drug. However my understanding is that once you take out the tourists, the Netherlands, with one of the most relaxed drug law systems in Europe, also has some of the lowest consumption rates.

Legalisation removes the need to rob and steal if addicts can get their drugs on prescription.

No it doesn’t. There’s no reason at all to link legalization with the prescription of drugs as a treatment for addiction. Australia has a very coherent and extensive harm reduction policy based around methadone maintenance treatment, and heroin use is illegal everywhere.

Paul Burns:

However, I gather hydroponic grass can cause mental illess

I think the evidence on this is still very weak, and most of the people pushing this line are hardened drug warriors. There’s a massive temporal confounder in studies of the relationship between cannabis use and the devleopment of mental illness which makes the effect almost impossible to identify.

tssk:

Given that either of the above entities would be selling or providing a product that is in the long term harmful how would we deal with legal liability?

If it’s heroin they’re trading, it’s short-term harmful not long-term, and the legal liability would be huge given that one of heroin’s main side-effects is death.

We’ve been around this road before on LP: heroin kills people, instantly and randomly, and any legal change which makes it easier to access for the young and the stupid is dangerous. We have a functioning drug policy, why change it for a crazy experiment with a dangerous drug?

We are doing things aimed at minimizing the short term damage of drugs (Such as needle exchange and safe injecting rooms.) However, some of these actions are probably undermining efforts to reduce long term drug abuse. For example safe injecting rooms only work because the police are not harassing people to carry drugs to the safe injecting rooms nor following these people when they leave so that they can arrest the drug suppliers. We have a defacto tolerance which means the drug lords continue to make mega bucks and the problem grows.
Reducing long term drug consumption means keeping drugs away from potential recruits. (My personal experience with nicotine and alcohol suggests that the bulk of the recruiting is done by drug users, not the drug lord organization. This means that tolerating users wandering around with small amounts of drug in their pocket is likely to be contributing to the recruiting of new users.)
In the case of an addictive drug like heroin the logical approach may be for combine the supply of heroin at the safe injecting rooms for use in the injecting room with harsh penalties for anyone found carrying heroin outside of the safe injecting room without authority.
Different drugs will need different strategies and some of the things that really work may not even require the drug to be illegal. For example, I have heard that the drug business at the Newman mine collapsed when the mining company introduced drug testing.

Personally, subject to certain conditions that would firm up provenance I’d be for full legalisation. One could have dedicated, licenced, audited outlets, where no actual cash changed hands, and where those with stored value cards would pay for specific substances at a specific quality.

We could start the thing as a pilot — with just marijuana and perhaps ecstacy to see how it would work. I’d favour dispensing the former perhaps as a nasal spray, a patch or perhaps a THC-based tablet — which would make provenance easier to track and control. I’d also permit growing/production at commerical scale under licence and growing privately for strictly personal use without a licence (though other drugs like MDMA obviously wouldn’t be permitted as the precursor chemicals pose a hazard to the public).

I don’t share the concern some have over heroin. Again, subject to provenance control I suspect we could design a system that would make it a comparatively safe drug to use recreationally.

Those so inclined could be asked to register, and be disbursed the drug at something like cost + service — again perhaps as a patch or nasal spray to deliver prescribed doses (so we cut out sharps). If they started going above manageable usage, they get called in for medical review. A centralised dBase stops them double dipping. Anyone trying to on-sell gets fined.

Fran, the plan you’re suggesting isn’t really “decriminalization” in the proper sense of allowing trade in the drug – it’s a kind of medical model with greater freedoms than the current one. It’s not necessarily incompatible with maintaining the illegality of heroin.

John D’s suggestion for heroin is also consistent with what was proposed by Bammer et al for Canberra before Howard stomped it.

Adrian, our drug control policy is not a futile waste of resources – heroin overdose deaths plummeted in the early 2000s under its influence, and HIV does not exist in Australian injecting drug users. That’s something you won’t find in many other parts of the world subject to an established heroin trade.

Legalisation removes the need to rob and steal if addicts can get their drugs on prescription.

No it doesn’t. There’s no reason at all to link legalization with the prescription of drugs as a treatment for addiction. Australia has a very coherent and extensive harm reduction policy based around methadone maintenance treatment, and heroin use is illegal everywhere.

Yes it does. Read this. Maintenence therapy is not designed as a treatment for addiction, but to address some of the other problems that opiate addicts have and cause. As a bonus, it does bring a notoriously difficult social group in contact with authorities who can offer and encourage addiction treatment services, as well as reduce the money going to criminal syndicates who supply the drug. I agree that legalisation of heroin is not neccessary for prescription heroin policies to be implemented – decriminalisation and medicalisation of drug problems is sufficient. Methadone and heroin are very similar chemicals with very similar effects – methadone treatment works mostly because it is undertaken voluntarily, and it is ingested rather than injected.

I agree that legalisation of heroin is not neccessary for prescription heroin policies to be implemented

i.e. you agree with me

maybe it’s a sad indictment of how the debate on drug policy has been reframed in the past 20 years but now when people think of “legalization” they think of dispensing methadone. “Legalization” means making drug use fully legal, but it seems to have changed meaning in the last 20 years …

Lol. I was just writing an apology for the comprehension fail. My point that maintence therapy is not just about treating addiction still stands though and Helen’s point that crime could be reduced with a different regime was valid (even if terminology was wrong)

I guess my problem with decriminalisation is that without a regulated supply, criminal syndicates still can monopolise the profits. Yet the trends in drug law reform, with cautioning and drug courts has been in that direction. Legalisation is not a dirty word or a bad idea and cannabis should be the first step imho.

Fran, the plan you’re suggesting isn’t really “decriminalization” in the proper sense of allowing trade in the drug – it’s a kind of medical model with greater freedoms than the current one. It’s not necessarily incompatible with maintaining the illegality of heroin.

I’d call it “legalisation” in the sense that it would make the currently illegal substances available through a regulated legal supply regime. Obviously, I’m not suggesting open slather any more than I’d suggest open slather for therapeutic agents that are currently available only on prescription. You wouldn’t need a “prescription” for heroin, but you might need to register as a user and (above a certain usage), subject yourself to regular (free) health checks, and so forth. The administration and service of this regime would be built into the cost of supply. That said, what it’s called is a secondary matter.

tssk asked:

Who would manufacture and sell the drugs? Private industry or the government?

I’d have it produced under licence to specification for the state by private producers. Any contraband seized could be graded and conformed to one or other standard or if that were impracticable, destroyed.

Given that either of the above entities would be selling or providing a product that is in the long term harmful how would we deal with legal liability?

In the same way that we deal with other products that fit that description. We give unambiguous advice to every purchaser, cautioning that the substances have the potential to be lethal and that no warranty of safety from any harm caused by the use of the product that cannot be shown to be the result of specific negligence relating to the specification of the product by the supplier is created by the purchase. We advise strongly that while every care has been taken, the safer course is not to consume the product because the possibility exists of the user’s long term health being seriously damaged.

If we were to write off legal liability (you buy the prescription you take the consequences) would this then not lead to legal challenges by other industries like big tobacco? If government sponsered smack is free from liability then why wouldn’t tobacco be?

As I understand it, the producers of tobacco are already free from legal liability for new smokers, except in cases where misrepresentation and negligence can be shown. Passive smoking is one example where liability continues, since passive smokers never consented and the tobacco industry denied ill-effects. That has been one of the consequences of the on-packet warnings, the removal of advertising, and wide publicity about the harmful effects of smoking. The scope for anyone to claim lack of awareness is nearly zero.

In the case of heroin, nobody could imagine that it would have anything but deleterious effects when used as a recreational drug. The centres dispensing the substance would be set up explicitly to cater to those who knew of these prospective harms but wished to consume the substance in any event. Accordingly, the position of tobacco would not be improved at all.

How do we deal with first time users?

The same way that we deal with longterm users. We advise them against use, make them sign a waiver saying they’ve read the caution, understand the issues and wish to releive the supplier of liability.

How do we deal with blowback from other countries? Our closest neighbours have hardline drug policies. How will they deal with having a large country at their southern borders as a vector for smuggling drugs into their country?

We let the chips fall where they may. It’s not our problem to sort out their own moral panic issues. We caution our nationals and others leaving our jurisdiction to respect the laws of other jurisdictions in relation to carriage of substances. We check people leaving our jurisdiction for substances illegal in other jurisdictions, and do checks on outgoing packages. Where someone has exported illegal substances, we prosecute, as this export would continue to be illegal here.

How will the US react given their hardline stance? Would we face trade embargos?

Improbable. America has much too much invested here to go down that road. Yet even if they did, so what?

The arguments surrounding harm reduction are not new, and to date they have failed to achieve the goal of shifting policy. The evidence, sadly, isn’t enough. What’s required is a new way to frame the argument in terms that overcomes the fear of the wavering parents, to the point where Labor feels comfortable enough to pursue reform, because we’re clearly not going to get anything resembling sane drug policy from the right.

I agree arguments about the well-being of drug users or evidence-based policy probably won’t work. But I still think drug law reform will happen because most Western nations are broke. The rallying cry will be “tax criminals out of business!”

Incidentally, I can’t find any comment from any federal Liberal or National politician on the report, with the exception of Dr Washer.

Federal Liberal MP and GP Mal Washer told the Herald Sun marijuana should be legalised so health professionals could manage problems “out in the open”.

Falling costs of policy? Declining imprisonment of those using illicit/illegal recreational drugs? Declines in lost working hours associated with policing the illicit/illegal recreational drug lifestyle? Declines in deaths and other adverse health consequences for those using illicit/illegal recreational drugs? Declining resources to criminal gangs? Declining police/customs corruption? Declines in street crime or burglary or declining insurance costs for homeowners and occupiers? Increasing liberty in personal lifestyle choices?

3. Are all illicit/illegal recreational drugs equally problematic?

Should different regimes for different substances be applied? Would opening the door to one substance subvert demand for a more harmful and difficult to control alternative? What is the overlap in the market between those overusing alcohol and those who might overuse marijuana, ecstacy or heroin?

4. If instead of spending — on some estimates, about $4bn per year on the “war on drugs” we spent, in net terms zero (since the state would now be charging a fee for supply and/or taxing producers and distributors and perhaps supplying medical marihuana or heroin to world markets), or even came out ahead, and had at least some of the benefits listed above as well, would that make a difference to your attitude?

I’d call it “legalisation” in the sense that it would make the currently illegal substances available through a regulated legal supply regime.

In that case we pretty much already have “legalization” of heroin use. Any heroin user can get access to methadone, and there’s mixed evidence on whether giving them access to heroin is better for them – the Canberra trial was only for people who had repeatedly failed on methadone treatment, because there is little evidence that heroin is better than methadone for the majority of users (and Bammer at the time wrote against seeing prescription heroin as a panacaea).

Allowing heroin prescription to operate in place of methadone prescription would be reckless, and allowing it to be extended to more people through the non-prescription process you suggest means more HIV, more deaths, and more of the health risks associated with injecting.

Also it’s cute to read you saying “what it’s called is a secondary matter.” I’m afraid that’s a tad hypocritical from LP’s resident pedant. Come up with a new term, or forever rescind your right to correct other people’s English!

I’m afraid that’s a tad hypocritical from LP’s resident pedant. Come up with a new term, or forever rescind your right to correct other people’s English!

Deary me! There’s no conlfict between being prescriptive on language and taking a different view on what “legalisation” means in practice and stating that that is less important in any event than what policy obtains.

I am as you know, very keen on calling the policy of pricing carbon emissions, a “carbon price” (rather than a “tax”) but if you ask me whether I think what we call carbon emissions pricing is more important than/as equally important as how we go about pricing carbon emissions over time, I will snort in derision.

It seems to me like there’s no real evidence about drug use. There are a many factors: Generally speaking drug policy is either more about drugs-related crime (both sale and robbery, etc.) or the health aspects facing users (both directly and indirectly, as in why do people do drugs?)

But there is no obvious solution. Or at least there seems not to be one. It seems to me that if you were studying the problem, there aren’t that many real alternatives to look at and while for a person focussed on the issue, the effects of drug abuse in the Netherlands and England might seem like one system is significantly better than the other, drug use is a problem in both countries.

And on a meta-level, the lack of alternatives is worrying– politically, we need to look for a solution and that means being creative and (responsibly) testing solutions in the real world. Without doing that, we don’t have any data and there can be no real development in the research. We can’t just talk about the drug problem and continually talking about how we want society to be doesn’t help either. As a country, we need to be more courageous in looking for a soultion to these kind of problems.

Unlike with global warming, where there is only one world, at least with drug taking it’s possible to try different systems and compare outcomes.

In my opinion, drug use in countries like Australia is generally related to either boredom and not having the chance to be involved in society or “spiritual hopelessness”– just not seeing the point of it all. People are going to say, “yeah, but drugs do actually feel good!” But they’re cheap thrills, they might alter the way our bodies percieve reality but they don’t change the way we feel pleasure. While there probably is a place for drug-taking in life, drug abuse is more a phenomenon related to our consumer society.

When is the Mars mission finally going to start?! We need inspiration and certainly I’m sick of hearing about the “War on drugs.”

I think it is important, Fran, because what you’re proposing is really just “decriminalization” under a medical model; legalization is something quite different. Alcohol is legalized; the model you propose is not anything like legalization. It’s important to distinguish between the two modes of drug use management because they have very very different social ramifications. It may offend your radical sensibilities, but everything you’ve written on drug policy on LP makes me think you are pro-decriminalization, not pro-legalization.

It may offend your radical sensibilities, but everything you’ve written on drug policy on LP makes me think you are pro-decriminalization, not pro-legalization.

As I see it, decriminalisation entails harassing drug users with petty fines — something like those that attend parking where it is prohibited. I don’t favour legal harassment of users. I favour them having a regime where the purchase, possession and use of drugs would be legally immune — unless of course you were trading in them.

That is very much like the regime that attends alcohol, though admittedly, one can purchase alcohol for others and the regime is not medicalised.

How do you propose to manage a “regulated legal supply regime” and how do you intend to stop it becoming “open slather” if you allow people to take their injectable drugs home? How will you stop people selling them, dividing them up and making a profit, etc. ? I’m guessing some sort of system of harrassment based on petty fines would soon present itself.

If you want the purchase, possession and use of drugs to be legally immune (<- I'm not sure that this is correct english – immune to what?), then you are proposing allowing heroin users to take their drugs home and shoot them up at home. How do you propose to prevent them a) overdosing, b) getting HIV / hepatitis C and c) suffering thromboses loss of limbs, all the various other crappy consequences of non medical injection?

In my opinion, drug use in countries like Australia is generally related to either boredom and not having the chance to be involved in society or “spiritual hopelessness”– just not seeing the point of it all. People are going to say, “yeah, but drugs do actually feel good!” But they’re cheap thrills, they might alter the way our bodies percieve reality but they don’t change the way we feel pleasure.

Richard Fiddler’s interview broadcast today is sort of relevant – an interview with a reporter who wrote a book on one police operation targeting where the money from the drug trade ends up. Apparently Australia is one of the biggest (per capita presumably) users of illicit drugs in the world! We’re not exactly the most disadvantaged society around so I wonder why we have such a fascination with drugs?

Chris, I think it’s a very simple reason: Australia is wealthy, close to Asia, historically had weak border controls and high levels of police corruption, and has a large migrant community capable of establishing trading connections with their countries of origin. This is also why heroin grew rapidly during the 80s and 90s: as the migrant communities from SE Asia grew larger they were in a better position to exploit their situation and bring drugs to the country.

People who think that Australia has it bad should consider the south west of China (China has an estimated 2,500,000 IDUs), the troubled states between Afghanistan and Russia, or Iran. Essentially, if you’re on a viable drug route, you have a drug problem. Australia is on a viable drug route, therefore we have a drug problem.

It has nothing to do with hopelessness or existential crises and everything to do with a bunch of dodgy people selling a product that is extremely addictive and (to some) very appealing.

and how do you intend to stop it becoming “open slather” if you allow people to take their injectable drugs home?

The drugs come in patches or a nasal spray or perhaps pills and of course, you only get some agreed amount per day. You can’t double dip because once you purchase, that’s it — just like the ATM, you only get so much per day. Someone with a serious dependency (as distinct from a casual user) would have to apply for special dispensation, and might have to have it administered on site.

If you want the purchase, possession and use of drugs to be legally immune (<- I'm not sure that this is correct english – immune to what?

to being a cause of prosecution — legal immunity … You may now rest assured.

It has nothing to do with hopelessness or existential crises and everything to do with a bunch of dodgy people selling a product that is extremely addictive and (to some) very appealing.

Yeah, could be right too. There are always going to be some that find drugs appealing– although it does seem that social environment does have some effect on making drugs more or less appealing. How much, who knows?

Just out of interest why shouldn’t I be legally allowed to grow a plant in my yard, say a poppy, or a salvia divinorum plant, or a cannabis plant, then harvest and consume it or its by products?

Why shouldn’t I be allowed to pick the psilocin mushrooms growing out of the cow shit in the paddock outside my front door and eat them (yum, cow poo), or cook them in pasta sauce?. Why shouldn’t I be allowed to extract that DMT from the phalaris aq grass in my back yard, or the acacia leaves in the tree in the same spot and consume them in the privacy of my own home?

There is all commercial pressure not to use drugs. If you could use drugs that you could grow yourself you wouldn’t do the normal thing a lot of people do when they are feeling down. Like buying a new pair of shoes or coffee or a smoke.

Fran and faustusnotes have bought me leaning further towards the decriminialisation side by the mention of herion and the instant death factor. At the moment a big problem we have is from overdose and death due to there being no standards. Alcohol, cigarettes and prescription drugs all have recommended dosages. At the moment a junkie is in the dreadful position of deciding whether the dose he’s taken is too small or just enough. And usually in circumstances where their judgement is impaired, either slightly high or in withdrawl.

Or to put it another way…say you suffer chronic migraines and there are no standards for headache tablets. But you know from past experiences that a whole box of the watered down tablets will cause the ache to lessen slightly. Then one day at random the tablets are full strength. And you and dozens of others end up in the emergency room with liver failure because you aren’t a lab technician checking the purity of the tablet each time.

Standardisation of doses would get rid of the overdose/overuse factor.

My main point was that criminalisation of flora and in some cases of simply consuming flora/fungi is ridculous. Especially, as alfred noted,
in an allegedly free society.

I completely agree wrt to ODs and an end to the criminalisation of heroin use. ODs may still happen but they should be far less likely given product with a regulated purity. Especially in an environment where information is available and users aren’t worried about legal troubles. Users safety will be further increased by the removal of their exposure to criminals, and the excessive prices and violence that goes with the drug trade, and the legal dangers.

I don’t think drug use is going to really increase due to any legalisation either. Drugs are everywhere, in every suburb or town, probably every street. If people want to use drugs they will find them, easily.

Alcohol taking is legal but we regulate where and where it is sold, where it can be consumed and the age of people it can be sold too. We also regulate blood alcohol levels for driving and the performance In some places we also regulate the strength of what is sold and ban access to alcohol for some people. Nicotine taking is also legal but it too but it is important to note that the regulations are different to those for alcohol.
There is no particular reason why the legalization of some drugs may to accompanied by appropriate regulations. What I suggested for heroin @8 is an example of legalization with strong regulation.
One point I would make though is that drugs have to be treated on a case by case basis. What I suggested @ 8 is not an appropriate model for cannabis.
I would also want to say that there are some drugs that should remain banned. For example, drugs like alcohol where users often become violent and a danger to others.

Making something illegal is only one of the strategies that can be used to reduce the damage caused by drugs. For example, the percentage of people smoking has come down over time. Education has been part of it but tighter and tighter rules about where people are allowed to smoke, banning all forms of advertisement and counter adds aimed at “de-cooling” smoking have all had their effect.
Testing of drivers and people at work has also had a much bigger effect than raising taxes. Losing your licence and/or losing your job is a much bigger threat to most people than being a bit more out of pocket or even dying of lung cancer.
In the workplaces that I am familiar with the employers and unions take the view that people must be in a condition to work safely and it is none of the employer’s business whether the drug being tested for is legal or not.

Alcohol, cigarettes and prescription drugs all have recommended dosages.

or

ODs may still happen but they should be far less likely given product with a regulated purity

and I have to ask: have you ever got drunker than you expected? Had a hangover you didn’t intend? Because if you can do that with alcohol, why should you think you won’t be able to do it with heroin? And with heroin, taking a bit too much doesn’t mean waking up with a headache, it means dying.

These two fundamental facts need to be explained before proposing legalization: how will you prevent the spread of HIV, and how will you prevent overdose deaths?

Fran, your model will obviously lead to diversion. Putting a limit on how much people can use is a recipe for an illegal market. How are you going to stop people purchasing those extra drugs privately? And what is the civil libertarian justification for allowing people a nasal spray but not a needle? And what will you do when people start importing injectable heroin?

The issue raised in Robert’s article and the Australia 21 report is not drug use as such but the failure of the war on drugs. The evidence of the consequences of the war on drugs is clear – criminalisation of drug use alone, ie where the drug use is unaccompanied by any other criminal offence, is a disaster for the drug user and his/her family.

The war on drugs means, for example, that you can be picked up by a sniffer dog while using public transport. Notwithstanding the coppers’ discretional capacity to issue warnings etc, there remains a risk that you can end up with a criminal conviction for doing no more than being under the influence of cannabis and in the possession of cannabis while catching a bus or a train and posing no risk of harm to anyone else at all. This is what the war on drugsmeans. What most respondents here do not appear to grasp is that the war of drugs is in fact a war on drug users.

More broadly the war on drugs has profoundly insidious affects when, as is my experience, FACS (previously DOCS) routinely fails to inform drug using parents of at risk children that the department’s official policy is one of harm minimisation. This means that the department officially accepts drug use by parents so long as the children are cared for by non-drug affected people while the parent(s) is so affected. The reality is that departmental child protection workers can and do see themselves as evangelical agents in the war on drugs. They prosecute this war by engaging in a war on drug using parents demanding levels of abstention, enforced by drug urine and hair sample screens, that habituated drug using parents simply cannot achieve. The end result is frequently, tragically, removal of children on inadequate grounds.

This is the sort of problem that arises when the state conducts a waron drug users instead of adopting rational policy. War, what is it good for? Absolutely nuthin.

Disclosure: my cannabis use commenced in about 1975 and ceased in 1983 until recommencing in about 1995. I like it, don’t drive ever under the influence and have never cause harm to anyone as a result of that use. I assert my right to use my drug of choice as a matter of personal freedom and preference.

“But what the winning message actually is, I don’t know.”
Sadly, depressingly I share this sentiment on this and a whole range of issues. Perhaps there was a golden age when reason prevailed, perhaps that’s a myth. One thing is for sure, reason ain’t got much of a look in these days (witness your quote from Vic police minister).

and I have to ask: have you ever got drunker than you expected? Had a hangover you didn’t intend? Because if you can do that with alcohol, why should you think you won’t be able to do it with heroin? And with heroin, taking a bit too much doesn’t mean waking up with a headache, it means dying.

Yes I have got drunker than I expected. But only cos I ended up consuming more alcohol than I expected I would before I started. Is that what you mean.

if you mean have I ever drunk such and such alcohol and ended up drunker than I thought I would given my previous history, then no.

There are bound to be guidelines with heroin – body weight, and tolerance, for example would change the amount of pure product one person could consume, but given all that there would be a safe range for most people.

These two fundamental facts need to be explained before proposing legalization: how will you prevent the spread of HIV, and how will you prevent overdose deaths?

The first – clean needles and other clean injecting gear would prevent the spread of HIV, in fact they have in Australia, which is one reason we have less HIV than might have been expected in 1988. Since we are doing a reasonable job of that now when the drug is illegal I imagine that legalisation would not interfere with our ability as a society to continue to inhibit the spread of HIV among IV drug users.

Overdoses are less likely with a regulated dosage regime, and a regular supply of heroin that doesn’t fluctuate in purity. Less likely. Not more likely.

Education wrt dosage to weight ratios and tolerance would also lower the likelihood of OD wouldn’t it? Especially for the sort of ODs where a heavy user has some time off the drug, lowers their tolerance and then dies cos they are used to a heavier dose.

Also as far as recreational drugs, especially pills – legality should mean certainty as to the product and safe dosage rates. No more kids dying of GHB overdoses cos they thought they were taking MDMA.

How do we prevent alcohol related deaths through drinking and driving?

One way has been to lower drinking and driving rates and part of that process was education using the concept of “standard drinks” and creating an awareness of alcohol dosage and the supposedly safe range of consumption.

Its not a totally compatible situation obviously, but that is one similarity. There is also a punitive side to the drinking and driving program, but thats not necessary if we are talking solely about safe consumption – not being drunk in charge of whats effectively a deadly weapon.

” the legal liability would be huge given that one of heroin’s main side-effects is death”
True, but it could be dealt with. Imagine going to a legal heroin dealer and asking to buy some. First off, it’s not something that everyone is going to do, we’re talking about a small subset of the population. So the dealer says that there are some potentially serious side effects and asks if you have the requisite insurances. So you say no and the dealer helpfully provides some brochures for various “heroin enjoyment support providers” and says that you can’t buy your smack until you can produce the proof of insurance. OK, so it doesn’t do much for protecting the kids but … it has a certain libertarian appeal. A provider would be prepared to take on the risk of death and the associated liability if the premiums were high enough and the rate of death was low enough. I think you could develop a schedule (of premiums) for all the currently illicit drugs except pot because with pot the effects are so slight that damage would be very difficult to prove so a dealer is not going to be exposed to much risk and the insurance becomes worthless to all parties.

@27
“How do you propose to manage a “regulated legal supply regime” and how do you intend to stop it becoming “open slather” if you allow people to take their injectable drugs home? How will you stop people selling them, dividing them up and making a profit, etc. ?”
Gad, it’s a nightmare scenario! I’m currently enjoying my own “regulated legal supply regime” i.e. home brewed all grain beer. As yet I haven’t felt the need to press it upon the neighbours for fun OR profit. I detect a whiff of poor white trash class warfare in this comment.

@33
Respect (cliche). I’m less that impressed by some of the hall monitor comments I’ve read in this thread. I heard Roxen say that we should be very cautious about loosening the laws because of the problems we have with booze. OK then, if prohibition is such a good idea lets bring it in on booze. Hypocrites.

In relation to heroin: it is abundantly clear that the drug could be dispensed by pharmacists at a standard dose per kilo for age/health and degree of dependency. Dispensing would be conditional on the drug being used on the premises with trained personnel available. No take away. So, most of the risks are removed (HIV, sudden death), dependency is accepted and the criminal ‘glamour’ removed entirely. Dispensing hours ought to be limited.

Yes I have got drunker than I expected. But only cos I ended up consuming more alcohol than I expected I would before I started. Is that what you mean.

Yes. Why did you have the extra drinks? Weren’t getting drunk fast enough? Felt a need to be drunker than you expected? A friend bought you some more? Why do you think none of these conditions apply to heroin users? Any such situation you are familiar with that could conceivably apply to heroin carries a risk of death. Not death because you drove home and crashed, but death because you died, on the spot, from the heroin you took. This is something that people quoting the “standard fixed amount” argument constantly forget: we take standard fixed amounts of alcohol regularly, it’s the drug we are most experienced and trained with, and we still fuck up – people who drink regularly still fuck up. Nobody drinks with the intention of getting a hangover, or getting so drunk that they don’t remember the night of fun with the handsome guy they woke up next to. And no one can predict their hangover, either – a quantity of alcohol that will have a pig shit in your head one night will lead to a mild grump another.

FFS, there are all kinds of urban myths about alcohol that no two people can agree on. We’ve had a culture of drinking for thousands of years and we still can’t get it right 100% of the time. You want to introduce a culture of injecting a deadly central nervous system depressant on the assumption the same problems won’t apply?

How do we prevent alcohol related deaths through drinking and driving?

One way has been to lower drinking and driving rates and part of that process was education using the concept of “standard drinks” and creating an awareness of alcohol dosage and the supposedly safe range of consumption.

There is evidence that most people don’t understand what a standard drink is, and can’t calculate how much they’ve drunk. The main way that we prevent alcohol related deaths through drinking and driving is through RBTs. This is a pretty well-established fact, I think. Why would mg of heroin be any different?

patrickb, it’s funny you mention homebrew, because my worst ever drug-related experience was with a poorly-brewed beer. There’s no “poor white trash” condescension in my comment – it’s a response to Fran’s suggestion that you can have a legalized regime in which consuming more than a certain amount is banned. Obviously people will rort such a system, and Fran’s idea includes the implicit assumption that this is bad. I’m just trying to point out to her that her system is not, practically, legalization, and will still require drug law enforcement.

The “poor white trash” condescension in this thread, in my opinion, arises from the idea that people take up drug use out of a lack of options, hopelessness, etc. It’s a real “they have a drug problem, I enjoy an occasional toke” kind of mentality, and it denies both the reality of drug use – that young people try it if they’re offered it, and keep doing it because it’s fun – and the dangers of addiction (because it assumes that if people were just happier in their lives they wouldn’t get addicted – no, addiction is a chemical process, and that’s that). Although there is research suggesting that criminality precedes drug use, I think it is wise, in general, when you see a drug addicted criminal bastard not to think “oh look, capitalism did him/her wrong,” but instead should consider the possibility that “there but for the grace of god go I.”

And for this reason alone we should be very wary about widening the availability of addictive and deadly drugs like heroin.

I too would love to grow some poppies and mushies in the backyard for home use, and actually tobacco too (not pot, it doesn’t agree with me.) But I don’t cultivate anything, because the legal situation is too dicey to risk my job over. I brew beer and cider at home because at least that doesn’t run afoul of any laws. But, well, yeah, it’s hard to see why folks can’t grow stuff at home for private use on their own premises: after all there’s no laws against people poisoning themselves with poor food hygiene in the kitchen!

It seems the damage done by illegal drugs is more in the dealing/distribution of them.

We have a completely schizoid set-up in Australia, where two very dangerous drugs are legal and widely available, but obviously regulated and taxed and restricted to adults. A lot of extremely dangerous drugs are available by prescription only (buprenorphine, anyone??).

A prescription model seems to be a good one for the addicts…safe, regulated, medically supervised. Should lower the collateral body count…and may also help to ‘de-cool’ the pill-popping and shooting-up: it’s one thing to be off your face at a nightclub, it’s another when you have to show up at 7.30am to the chemist!!

But, in general, when it comes to drugs, what’s wrong with the ‘mind your own business’ principle? If you’re against drugs, don’t take them. (If you’re against gay marriage, don’t get gay married; if you’re against contraceptives, don’t use them; if you’re against abortion, don’t have one, etc…)

Oh, and I’ll just add, I don’t know a single person whose quality of life was improved by taking heroin or amphetamines. Do you? But I actually know quite a lot of people who, despite the inevitable health problems, have enjoyed a higher quality of life using tobacco, mushies, pot, booze, ekkies, etc… (obv. not all the same person, and not all at the same time!!!)

it’s a response to Fran’s suggestion that you can have a legalized regime in which consuming more than a certain amount is banned. {…} I’m just trying to point out to her that her system is not, practically, legalization, and will still require drug law enforcement

There’s drug law enforcement around alcohol too, which you regard as legal. A person carrying prescription pills for which he or she holds no prescription is subject to law enforcement. Cars are legal but you must observe road rules.

It’s certainly possible that some addicts might contemplate wanting to go above the casual threshhold, but I rather suspect that they’d simply wear the “problem user” tag and get their extra on site (and wear also the extra medical checks and intervention. Most of them accept they have a problem. Far easier and legal.

I think it is wise, in general, when you see a drug addicted criminal bastard not to think “oh look, capitalism did him/her wrong,” but instead should consider the possibility that “there but for the grace of god go I.”

OH FPS … While capitalism did him/her wrong is certainly much too simplistic, it’s also part of the answer. The fact that most people who use licit and illicit mind altering substances don’t become drug addicted criminal bastards (your phrase, not mine) has nothing to do with the ‘grace of god’ (whatever that may mean in your apparently metaphysical fantasy) but the fact that they had the benefit of an at worst adequate circle of carers around them when they were becoming adults.

Alcohol has been freely available to me for my entire life and yet I’ve been into a venue (excluding restaurants) where alcohol was served on perhaps a couple of dozen occasions and have been somewhat affected by alcohol on two occasions (at 19 and 24). The deity did not advise me, nor did fortune help me evade the demon drink — or other drugs.

Mercurius is right. The none-of-anyone-else’s-business principle should kick in, though we should endeavour to create a legal and regulated regime around usage in inter alia order to

a) discourage those so disposed from doing themselves unanticipated harm (the fence at the top of the cliff is better than an ambulance below)
b) reduce transmission of blood borne disease and other co-morbidities
c) reduce contact between the justice system and users
d) reduce threats to the integrity of the police force(s)
e) reduce lost working time
f) augment the freedom of people to choose their own lifestyle(s)
g) deny funds to crominals and reduce accociated criminal activity
h) improve access to legal analgesics
i) lower the cost to the public of law enforcement action

Sorry I’m late, school hols.
Prohibition has failed. Most intoxicants are dangerous and prohibition has made them more so.

The dispensing of di-morphine by pharmacies has been tried in Australia, quite successfully. The British Medical Association ( no AMA back then) campaigned strongly, but obviously unsuccessfully against the criminalization of di-morphine/heroin in the 50s. Their letters and briefing papers from the time seem remarkably prescient. Family legend has it that an uncle returned from a German pow camp addicted to methadone, the Germans having lost access to opium invented a substitute. Drs prescribed di-morphine. For the next eight or so years he picked up his script once a week on his trip to town and took it back to the farm. Literally thousands of returned servicemen had similar experiences.

We should give di-morphine back to the drs, the police have only made the situation worse.

Oh and opium poppies are a ferel weed in Melbourne. They have been an ornamental plant for yonks. I’ve seen them growing in front gardens two or three doors from police stations. Our first spring in this house saw half a dozen pop up in the front garden. How I laughed.

f-n, i do think you are right to worry about overdosing. I’m not trying to make light of a serious issue.

But I still don’t agree.

For a start heroin isn’t a fun drug. I used lots of drugs in the 90s. When we had an injecting culture that developed out of the reaction to HIV. People who would never have considered IV drug use did so cos it was possible to do it reasonably hygienically. The supply of clean needles and injecting gear made it possible to “safely” inject all sorts of things. It seemed in the early 90s that everyone in Melbourne was an IV amphetamine user. (And I agree with Merc – it doesn’t really do anything to enhance your life.)

I used heroin a handful of times, and found it boring and unpleasant. It made me throw up, fall asleep and disconnected me from what was going on around me. I would binge on amphetamines and pills and trips for days and smoke cannabis to come down. Many people I know used heroin to get through that period – coming down. Many of them developed habits and a few died. Most stopped after a few years of very mild use because they actually developed habits that caused discomfort without the drug. Got addicted once and never went back.

The few who “stuck with it” and ended up with habits that have lasted 20 years have all expressed the view that it makes them feel “normal”. Not that they have more fun on it, or that life suddenly becomes a party. Some led functioning normal lives as addicts. Held down 9 to 5 jobs and did “normal” things while they had access to the drug.

So I dispute the idea that heroin use is “fun”. To me it seems long term heroin use is a symptom of problems in a person and that their use is an attempt to normalise. Admittedly that only an anecdotal observation but seeing as it applies to every long term junkie I know then its probably got something of the “truth” about it.

I’m not trying to make light of your point tho. OD is a serious issue and a very real risk. I just happen to think illegality makes it more likely. All the people I know who died from it did so while heroin was illegal.

But … ok its a CNS depressant like alcohol, and as a society we have problems with alcohol. Lots of people drink and its not always for the fun or social aspects of drinking. So there is a chance that with legal heroin more people will use it instead of alcohol … thats something many people don’t take seriously.

Secondly drink driving rates have fallen in Australia, as has the number of road deaths connected with alcohol, especially as the number of drivers rise. This would suggest that people are aware of the number of standard drinks they have and the effect of standard drinks on their BAC. RBT and education about standard drinks go together and have since the 80s when RBTs were introduced, and I dispute that evidence you provided that shows people don’t understand what standard drinks are, especially when the link itself says:

Discussion and Conclusions.Standard drink labelling is an effective but little used strategy for enabling drinkers to track their alcohol intake and potentially conform to safe or low-risk drinking guidelines.

Standard drinks are used in Australia, have been for ages and enable people to keep track of their drinking. People may behave inappropriately afterward, or not, but in relation to drink driving they are able to use standard drinks as a guide and do. As far as health and standard drinks goes … I don’t think people actually believe the current guidelines – the ones that say for example, that four standard drinks is binge drinking. People know that 3 stubbies in 2 hours puts them near or over the limit – what they do with that knowledge is a separate issue.

I’m not trying to argue heroin is a harmless drug – far from it. I’m just saying that prohibition causes more harm than it prevents.

The none of anyone’s business is the way to go imo wrt to recreational drugs. (I don’t consider heroin to be a recreational drug tho.)

Years ago I remember R U Sirius making the point that he’d like to go to his doctor and say “I use Ecstasy once a fortnight, and in the process dance all night – what should I be doing to enable this with a minimal impact on my health.”

And get an answer from his Dr that outlined the risks, what diet or supplements he may need to minimise the come down and associated effects etc etc. Not a lecture on the dangers of drugs.

That is the sort of maturity we need as a society wrt to “illicit” drug use. After all there are good arguments that without drugs – specifically psychedelics, then our society would be unrecognisable. Especially now that so many people have smartphones. There are also good arguments against roads full of people tripping off their heads while driving.

I walked into a chemist and asked for a large guage hyperdermic needle. Was responded with a “We harn’t THAT kind of chemist”

Bit of a surprise. They were two doors down from a pet store that sold snakes, and I needed something to inject vitamin supplements into a rat.

Managed to pick up a insulin needle from a friendlier/saner chemist down the road – but being an insulin needle was too fine to pass the particulate matter through it (crushed up pills rather then properly disolving vitamins).

Jules “So I dispute the idea that heroin use is “fun”. To me it seems long term heroin use is a symptom of problems in a person and that their use is an attempt to normalise.”. Heroin is fun for some people, just not many. Studies done in the wake of the vietnam war suggest that only 10% of the population find heroin use attractive. As for the feeling normal, the ancients were way ahead of us. One of the stories about Demeter, was that as she searched for her daughter, Persephone, abducted by Vulcan, she found a land of poppies. The people there seeing her distress gave her some “milk” to drink. She stayed with them for about ten years then became restless and returned home and found her daughter had escaped Vulcan’s clutches. These days the average period of heroin addiction is about ten years and the people attracted to it are often traumatized to begin with. Opium and it’s derivatives are great drugs for forgetting. Which is a good reason for treating them with caution.

Fran, you show a touching naivete about the nature of drug use and the lengths people are willing to go to get high. I think you’ll find that the way heroin is used and the nature of drug addiction will prevent your idealistic model from ever preventing the problems currently being experienced. Also, you shouldn’t take phrases like “there but for the grace of god” so literally, or be so rude about them.

Regarding blood-borne viruses, we shouldn’t make the mistake of thinking that needle syringe programs (NSP) are a panacaea. They certainly worked to prevent the spread of HIV and then eliminate it in drug users, but hepatitis C virus (HCV) prevalence remains very high (50% or over), and is declining slowly if at all. Surveys consistently show 20% or so of IDUs have shared needles in the past month despite the presence of NSP, and until that rate drops we won’t see a decline in HCV.

Also, we never had an injecting culture that developed out of HIV. Heroin imported into Australia is easily injected and there is a natural progression from smoking to injecting that is well understood. The idea that NSP created injecting is fallacious.

Heroin overdose needs to be seen in the context of other forms of out-of-control drug use, and the recklessness with which young people engage in drug use. Once we accept that a lot of people can’t use alcohol responsibly despite knowing their limits, we have to recognize that OD remains a serious risk in a legalized environment. The difference is that we are going to make the drug more easily available to more people – widening the pool of people at risk of OD and HCV.

Finally, drink driving was reduced by making it illegal and introducing RBTs, not by education alone – I think this is a pretty well established part of public health theory. Standard drinks were introduced later to improve health (women 2 and men 4).

Regarding Hepatitis C – one of the largest vectors is needle sharing in prisons. There is research available on this in the Australian context.

A prescription heroin program that is not aimed at treating addiction is just that – a maintenence program. It’s a harm minimisation measure that aims to reduce drug overdoses simply by ensuring the user has the knowledge about the strength and purity of what they are injecting. It will not eliminate overdoses or injecting risks – the aim is to minimise the risk of harm. At the moment, MSIC just resuscitates people who overdose – prescription heroin is a strategy to reduce the number of overdoses. Incidentally, MSIC actually introduced a strategy of using narcan as a last resort, because some addicts who overdosed and were treated would then go and procure more drugs because their ‘high’ was interrupted. This increased their risk of overdose at their next usage.

Added benefits – money going to criminals who sell heroin is reduced and crimes commited by heroin addicts is reduced. Plus they are in contact with medical professionals who can advise on vein care, other risks etc as well as offer treatment services. Like methadone.

Its not a panacaea. Its a harm minimisation measure.

Still no comment from any Federal Liberals or Nationals on the report. I’m willing to bet they will legalise cannabis as a revenue-raiser.

yuppiegus, the highest incidence of HCV is in young users – about 70 per 100 person years amongst IDUs under 20. Recent results suggest incidence rates out of prison of up to 40 per 100 person years, higher than those in prison (between 4.5 and 30 depending on the study). Prison NSP is essential but the reality is that HCV rates are high in prison-naive populations, despite the availability of clean needles.

I very much doubt the MSIC is introducing narcan to stop people taking a second shot. I suspect they use narcan to prevent people dying of overdose. I can’t see the link at all, actually – it’s standard practice for post-OD IDUs to go and get another hit after a narcan shot, and I’ve had a man emerge from his near-dead state, freshly revived by naloxone, and start yelling at me for interrupting his high. What do you think he was going to do once the ambos were gone? Narcan doesn’t stop the habit of post-OD re-injection.

And yes, NSP and methadone are harm minimization measures. Because the only way to prevent harm from heroin is to stop people taking it.

Just imagine the results of spending all that money currently wasted on the incompetent and moralistic war on drug users on subsidised access to mental health services. Maybe this might reduce the number of self medicating illicit drug users especially those traumatised who are trying to forget, numb out or just remember what it’s like to feel happy again.

Also, we never had an injecting culture that developed out of HIV. Heroin imported into Australia is easily injected and there is a natural progression from smoking to injecting that is well understood. The idea that NSP created injecting is fallacious.

Bullshit. If it wasn’t for needle exchanges then most amphetamine use in melbourne in the early 90s wouldn’t have been via needles. I remember hearing that 15 to 20 % of 18 to 34 yr olds had used amphetamines and around 80% of those people had used needles. And that the needle use figures were up significantly (among amphetamine users) since the needle exchange program started.

That figure certainly approximated my experience.

Nearly everyone I know who got into injecting speed wouldn’t have if the gear to do it cleanly wasn’t available in every suburb easily.

Finally, drink driving was reduced by making it illegal and introducing RBTs, not by education alone – I think this is a pretty well established part of public health theory. Standard drinks were introduced later to improve health (women 2 and men 4).

No not by education alone I acknowledged that back @ 43 tho its nice of you to remind everyone. Education enabled people who chose to drink responsibly to make informed decisions about how much they had consumed and whether they would be under the legal limit if they were RBTed. Standard drink labelling has been in this country for 20 years at least, and the concept has been around longer.

And yes, NSP and methadone are harm minimization measures. Because the only way to prevent harm from heroin is to stop people taking it.

And how do you propose to do that? Cos prohibition certainly hasn’t done it.

Go back to what dwlah @ 55 said. What were the OD rates when heroin was available via chemists in cough medicine? Lower than the rates in the 90s vbefore the Taliban banned Opium production? Probably.

Faustusnotes: My son has been extensively involved in overdose and needle transferred disease research both here and in the US as well as programs aimed at reducing both these problems. He has made a few of interesting comments to me on the OD problem.
Firstly, “if you can keep drug users alive for 10 yrs they will usually get their act together and get on with their lives.”
Secondly, the risk of heroin OD increases the longer it is used. Apparently the dose required to OD stays much the same while the dose required to have an effect gets higher and higher. Older users are also more at risk because they are more likely to shooting up on their own with no-one there to help. (It is usually possible to keep someone alive using CPR until they recover – at one stage my son was involved in teaching CPR to the drug dealers of Perth so that they could keep their customers alive.)

Fran, a little hint: that phrase has nothing to do with religion and everyone knows that. Or are you being deliberately obtuse?

Jules, heroin has been injected – pretty much exclusively an injectable drug – since the 1970s at least. Your stats on amphetamine injection may be correct but they show no evidence that this process is due to NSP. I suspect that amphetamine injection has more to do with changes in the composition of amphetamines that made them more injectable, due to changes in laws on precursor chemicals. NSP was introduced in 1987, FFS, and by that time heroin injecting was a pretty common phenomenon. HCV prevalence among methadone maintenance clinic attendees in the 1970s was above 70%, clear evidence that injecting was common even then. It’s now around about 50%, so 20 years of NSP hasn’t changed that problem very much at all.

From memory, HCV will become the leading cause of liver transplant by 2015. That is, even though we only have about 100,000 IDUs in Australia, as compared to millions of drinkers, injecting will replace alcohol as the lead cause of liver transplant. A policy that makes heroin more readily available will make this problem bigger.

You have your facts on RBT and standard drinks all wrong. The first RBT was introduced in 1982, and bac limits had been around since the 1960s. Driving fatalities fell rapidly by 1984. The first standard drink campaign was introduced to Australia in 1987 under the Hawke government, and by then mortality due to drink driving had already fallen significantly.

The Taliban are irrelevant to Australia’s drug trade: it comes from South East Asia.

Prohibition has worked in Australia: overdose deaths fell significantly after the heroin shortage, as did numbers of new users entering the market, minor drug offences, and prostitution offences. It’s no coincidence that this event came after the Woods commission. It’s possible that Australia is the only country to have actually tried to prohibit heroin use.

Does out of prison rates = prison naive or do out of prison include ex-prisoners? I haven’t seen the research your referring to, but if what you say is true about young injectors than we do need some more targeted education programs regarding needle-sharing.

You mis-read this time I said Narcan is used as a last resort – going from memory but I think MSIC uses oxygen to prevent the problem I mentioned and you apparently have experienced first-hand.

And the only way to prevent harm from alcohol is to stop people drinking it. Stopping people using drugs is pretty much impossible to do in modern society, and current practices have ‘externalities’. Like multi-billion $$ criminal empires, and drug addicts using substances of unknown quality and purity (and hence higher risks of overdose). If risking death and jail-time doesn’t stop people using drugs; what will?

Please dont stop commenting just because of the pile-on in your direction. I’m listening.

Apparently the dose required to OD stays much the same while the dose required to have an effect gets higher and higher.

Not true JohnD. Heavy heroin users develop tolerance so that they may be using recreational doses that would kill a novice.

Fran, a little hint: that phrase has nothing to do with religion and everyone knows that. Or are you being deliberately obtuse?

I don’t agree that ‘everyone knows that’ though I’m not sure how one could prove that anyway. If YOU don’t intend that then perhaps it would have been better to have said what you actually meant, especially when I invited you to be specific. Your failure to do so suggests that your “little hint” was a big pice of obfuscation. Saying ‘everyone knows that’ is simply being non-responsive.

Sidebar: Here’s someone who thinks it has quite a bit to do with god or religion:

Meaning: I too, like someone seen to have suffered misfortune, might have suffered a similar fate, but for God’s mercy. {my emphasis}

It continues:

In recent times, this proverbial saying is often used without the literal belief in the Christian God’s control of all things and is used by believers and nonbelievers alike. It is frequently suggested to have been coined in a more pious and devout era. The story that is widely circulated is that the phrase was first spoken by the English evangelical preacher and martyr, John Bradford (circa 1510–1555). He is said to have uttered the variant of the expression – “There but for the grace of God, goes John Bradford”, when seeing criminals being led to the scaffold. He didn’t enjoy that grace for long, however. He was burned at the stake in 1555, although, by all accounts he remained sanguine about his fate and is said to have suggested to a fellow victim that “We shall have a merry supper with the Lord this night

Apparently there’s no direct evidence over this provenance but wiktionary comments:

Proverb: there but for the grace of God go I

1.A recognition that others’ misfortune could be one’s own, if it weren’t for the blessing/kindness/luck bestowed by fate or the Divine.
2.Man’s fate is in God’s hands.
3.More generally, our fate is not entirely in our own hands.

Usage notesThis proverb is an expression of humility; in using it, a speaker acknowledges that outside factors (such as God’s grace, or his upbringing) have played a role in his success in life.

So in addition to god or religion — cited first — there are generic “outside factors”.

The “Free Dictionary” realtes it to “the fall from grace” — which is again religious.

Fall from grace
1. . Lit. to sin and get on the wrong side of God. (A Christian concept.) It was either fall from grace or starve from lack of money. That’s how thieves are made. Given the choice between falling from grace and starving, few people choose to starve.
2. Fig. to do something wrong and get in trouble with someone other than God.

yuppiegus, prison-naive means never in prison – and I was using under-20s as a proxy for prison-naive, so it’s not 100% accurate. By “out-of-prison” really I meant “general community” (i.e. those with a prison history and those without) but if the rate in the general community is higher than that in prison, and the general community includes people with a prison history, then people who’ve never been to prison must have even higher rates than those who have. For evidence, try van Beek et al (1998) on young injectors; Dolan, 2003 on prison rates (I’ve left out the link so I don’t get moderated); and there was a nice overview by the department of health in 2006.

The point is that all the evidence for 15 years shows that HCV is an environmental hazard for injecting drug users. The only way to prevent it is to stop people injecting, and the work of many researchers over the past 20 years shows that this is very hard to do in Australia (see e.g. Maher, Running the Risks which again I can’t link to due to moderation). This is a kind of sad mathematical fact: when prevalence of a disease is high it is extremely hard to prevent its transmission through behavioral change, because even relatively minor lapses maintain the disease’s prevalence.

But what legalization means for heroin is that more people will be using this drug, which widens the pool of people at risk of HCV. If you consider legalization in the USA, it’s even worse – prevalence of HIV is up to 9 or 10% in IDUs now and even higher in some sub-populations; HCV can be as high as 90% or more in some areas. You expand the pool of people using heroin when a large number are already HIV / HCV positive and there is no established culture of clean needles, and even if you introduce very good NSP you are really playing with fire.

And, incidentally, the USA gives a good counter-example to Jules’s point about NSP encouraging injecting, as do Thailand and China, none of which countries had access to NSP until recently. People in rural areas of Thailand were injecting for years before they even had access to any kind of needles (they used these kind of home-made thingies). China has introduced NSP and MMT, but they have a huge problem with HIV in IDUs that existed before they introduced NSP (and NSP coverage is still limited). It’s believed that HCV entered Australia in the 1950s through Southern European migrants who had a culture of reusing glass needles for administering medicines. NSP is not the cause of injecting cultures.

If risking death and jail-time doesn’t stop people using drugs; what will?

The heroin shortage stopped a lot of people using drugs. It was brought about by successful prohibition.

Q. Who would manufacture and sell the drugs? Private industry or the government?

A. Government.

Q. Given that either of the above entities would be selling or providing a product that is in the long term harmful how would we deal with legal liability?

A. Same way the car and alcohol industry handle it.

Q. If we were to write off legal liability (you buy the prescription you take the consequences) would this then not lead to legal challenges by other industries like big tobacco? If government sponsered smack is free from liability then why wouldn’t tobacco be?

A. Because the heroin overdose was due to misue of the drug. Smoking damages your health regardless of how you use it.

Q. How do we deal with first time users? If we don’t sell to first time users period what sort of other issues are we creating? Would crime syndicates manufacture and sell drugs to unregistered users? Or is it more likley that they would get the drugs directly through registered users either by money, intimidation or force?

A. We allow people to apply to take the drug whether or not it is the first time. No glamour in it though.

Q. How do we deal with blowback from other countries? Our closest neighbours have hardline drug policies. How will they deal with having a large country at their southern borders as a vector for smuggling drugs into their country?

A. It would not be legal to commercially produce heroin. So there would be nothing to smuggle.

A. How will the US react given their hardline stance? Would we face trade embargos? Banning or extra screening of Australian citizens?

As an aside about HCV and prisons, I’m doing modeling on this (and other aspects of HIV in China, Japan and elsewhere) at the moment and, just as with a lot of STIs, at a population level there are two key variables defining frequency of contact and risk: proportion of injections that use a shared needle and number of injections. In prison, the former goes up a lot but the latter goes down a lot. So while it seems prima facie a perfect transmission environment because of lack of access to clean needles, the overall effect of prison can be to reduce risk through reduced numbers of injections. In fact, entry to prison in Australia can be a positive health benefit for heroin users: they gain weight, they go onto methadone treatment, and they reduce or eliminate injecting as well as getting access to much-needed healthcare. No one wants to send anyone to prison, and one goal of the last 20 years of drug policy in Australia has been to reduce the risk of sending people to prison despite the illegality of the drug; but it doesn’t have to be the case that going to prison is bad for heroin user’s health or stability.

Just as with the debate about health systems, I find it really disappointing that the debate about drug policy is defined entirely in terms of what happens in the USA. Australia’s policies (and China’s, for that matter) are not those of the USA, and we don’t prosecute our drug war the way they do; we should be talking about what actually happens in Australia, not arguing with straw Americans.

But what legalization means for heroin is that more people will be using this drug, which widens the pool of people at risk of HCV.

We agreed earlier that a prescription heroin program doesn’t require legalisation. Like the MSIC, it could be limited to existing users under a decriminalisation/medical model. As an added benefit, it could be provided in a manner that isn’t injected if the addict desires (or could be convinced of its benefits). It could be provided in a form that’s inhaled or ingested – both of which were the traditional methods of consumption. It’s long been argued that prohibition increases the motivation for injecting because its the most cost-effective means of consumption to get the desired result, and prohibition increases the price of the drug. But I am unaware of any drug research that supports that theory – it comes from economic theories.

The heroin shortage stopped a lot of people using drugs. It was brought about by successful prohibition.

The heroin shortage stopped a lot of people using heroin. I haven’t seen conclusive evidence that it was brought about by prohibition.* It’s probable but we don’t know. It could’ve been economic factors as well.

During and after this same period of ‘effective’ prohibition, we saw the explosion and normalisation of amphetamine markets (I actually think its possible this could have been caused by prohibition more effectively limiting ecstasy precursors but that’s just a guess and if its true, I’m not sure it’s desirable either), and increases in cocaine consumption, which similarly to heroin, is imported. Prohibition was the policy before and since 2001 and heroin use and harms are now trending towards back to where they were in the mid-90′s. Prohibition ain’t no panacea either.

I’m curious fn, do you have any objection to the legalisation of LSD? Or cocaine? And what do you think law enforcement are doing differently now since 2001 that has caused an increase in heroin availability? What do you make of Mick Palmer’s comments?

It will take me some time to go through your references, and I will be unable to comment for a couple of days due to lack of internet access.

*One undesirable effect of the heroin shortage was a change in importation methods, which has led to unprecedented numbers of Australians being arrested overseas as ‘drug mules’. Some of whom were children, who risked facing the death penalty.

hello yuppiegus
i’ll have a go. the libs will only decriminalise pot when they repeal compulsory voting. if. perhaps in the name of ‘conscious rights’, those seem to be all the rage now amongst republicans & republican clones. disengage ‘em from politics & feed ‘em soma – ‘brave new world’ all over.

is this perhaps the moral/social/political situation the establishment fears will be at the bottom of the slippery slope of “state supplied/state sponsored drugs on demand” for the masses?

imagine, do they say to themselves, imagine a (developed) world where masses of the populations tune in, turn on, and drop out? the economy? technology? politics & political allegiances? (who, for example, would vote for the party with a platform to limit access to soma? or increase access to soma?).

or, is this how they plan to manage large scale unemployment & crippling environmental degradation after the coming crash? drug ‘em & park ‘em?
cheers
a.v.

Nick, I’m not sure what table you’re referring to in the Kirby institute report, but the incidence table I can find is on page 100, Table 4.3.1, and it’s from the same source (the Kirketon Road Centre) as van Beek et al., just updated for later years. Unfortunately the numbers of people in the under 20 age category are very small so it’s hard to make a judgment, but your 25 per 100py seems about right. This is after the heroin shortage, i.e. in the successful prohibition era. I don’t think you’re missing anything, but I think this supports my view that prohibition is an effective way of reducing the harms of drug use: by restricting supply you reduce the number of injections people can do, and force them out of the market – which in Australia means onto methadone, leading to further reductions in injecting.

The other report you link to, Table 14, doesn’t say what you claim. 15-19 year olds were 3% of notifications in 1995, rising to 6% in 2000, then dropping to 3.5% in 2004. i.e. there was a strong upward trend that reversed after the heroin shortage. I published this data in BMC Public Health in 2006 but I don’t like using notifications as a marker of incidence – they’re too vulnerable to changes in medical practice and I remember that in the late 1990s we were running a drive for increased testing of HCV, so the drop could just represent a reduction in the number of positive young people who hadn’t yet been tested.

yuppiegus, I’m entirely in favour of a prescription heroin program, but under a medical and not a civil liberties model, i.e. no takeaways and no legitimizing heroin use as a recreational drug. On other drugs I’m much more sanguine – I support decriminalization of cannabis and would be pro-legalization if it weren’t for the cancer issue, and I think ecstacy really isn’t dangerous. Amphetamines and cocaine I don’t have an opinion on.

As for whether prohibition was the reason for the shortage, there is a large report by teh National Drug Law Enforcement Research Foundation that claims it was. The reason, I think, is that between 1998 and 2001 Australia experienced a perfect storm of anti-heroin changes: the reform of the police force due to the Woods royal commission began to hit the streets in 1998; the drug summit of 1999 led to an expansion of methadone treatment from 1999; better coordination between police and customs had been ongoing from the mid-1990s; and Howard’s Tough on Drugs strategy included significant funding for customs and regional coordination. This all came together in 2001 to force many criminals out of the heroin market, and simultaneously to give vulnerable people an exit choice that protected them from having to make dangerous choices when the supply dried up.

I think it’s safe to say that Australia is the only country that has ever even tried prohibition, and I’m not surprised by the outcome: when the state throws serious resources against organized crime, it will always win. But in past eras governance problems and corruption have always prevented the state from doing this. After necessary reforms, Australia was able to actually act on its policy goals, and did it well.

@faustusnotes – Ecstasy (MDMA) is dangerous. If you take too much of it, or if what you take is contaminated with dangerous substances, it kills you. This is why the market needs to be regulated, ensuring a clean supply with a consistent purity level so users can be sure they are taking a safe amount and not poisoning themselves.

The exact same goes for heroin (and many other substances, including water). You need to let go of the idea that you have the power to stop people from using drugs. You don’t, and you can’t stop people from committing suicide either. What you can do is reduce the risk of accidental deaths.

Thanks, faustusnotes. I’ll come back to it in a few days’ time. Table 4.2.2 was the one I was referring to (rightly or wrongly?). Table 14, I wasn’t claiming anything from as such…was open to the idea that it might support what you’re saying, and also interested in your general thoughts on notifications.

“What’s required is a new way to frame the argument in terms that overcomes the fear of the wavering parents, to the point where Labor feels comfortable enough to pursue reform, because we’re clearly not going to get anything resembling sane drug policy from the right.”

Possibly by emphasising how the war on drug users effectively means giving money to criminal gangs. As someone on the right once said:

See, if you look at the drug war from a purely economic point of view, the role of the government is to protect the drug cartel. That’s literally true.
― Milton Friedman

I think it’s safe to say that Australia is the only country that has ever even tried prohibition, and I’m not surprised by the outcome: when the state throws serious resources against organized crime, it will always win. But in past eras governance problems and corruption have always prevented the state from doing this. After necessary reforms, Australia was able to actually act on its policy goals, and did it well.

Proof positive, fn, that you’ll argue yourself blue in the face on ascertainable data in order to be seen as right while steadily distancing yourself from actual, existing reality.

After necessary reforms… we now live in the best of all possible worlds!

Nick, Table 4.2.2 reports trends in prevalence, which can be indicative of the dynamics of HCV infection but aren’t a guarantee of such. The trend in people aged under 20 appears to be increasing but then crashes in 2009, but the increase and the crash likely just reflect the small numbers of people being tested (about 40 per year). It’s better in any case to use well-designed incidence studies in cohorts which, despite obvious selection biases, give an accurate estimate of incidence rates in the groups they’re representative of. Since 2001, however, the population of IDUs has aged rapidly (probably due to new, young users dropping out after the shortage), and it’s hard to maintain a large cohort of young IDUs. Also, if the average age of initiation is 17 or 18, the most that anyone entering a cohort will contribute to the under 20 category is 2 person-years of risk, so you naturally have reduced sample sizes in that category.

akn, do you have an alternative explanation for why heroin overdose deaths dropped by 70% in one month and stayed low for the following 3 years? I’m sure it will be much more firmly grounded in evidence than mine is.

f-n: you utilise cheap rhetorical tricks especially one called “moving the goalposts”. You make the general claim that “prohibition has worked in Australia” when it clearly hasn’t. The evidence that it hasn’t worked is the availability of heroin. For prohibition to be successful there would have to be none.

You also say that evidence for the success of prohibition is the lowering of heroin overdose deaths. Except that criminalisation of drug use is not designed to lower rates of death It is designed to punish drug users. If the aim of social policy was merely to reduce heroin overdose deaths there are other pathways to that outcome as you would be aware. It is clear that criminalisation and prohibition is a moral issue for policy makers when numerous humanist alternative policies are available.

So, I reckon you’re just another anti-drugs moralist operating undercover as a public health epidemiologist.

This is the point of the Australia 21 report: the war on drugs has significant costs that are never acknowledged by morals campaigners like you.

This is the point of the Australia 21 report: the war on drugs has significant costs that are never acknowledged by morals campaigners like you

Which is of a piece with his ‘grace of god’ observation above. FN might or might not be a religionist, but at the heart of the offhand remark is a denial or at best minimisation of the salience of human agency. Anyone could become the victim of an insatiable appetite for what for him is a morally reprehensible practice.

There’s also a touch of the AYBABTU doctrine as well — which, slightly reconfigured, stands for .. all your body are belong to us.

It is undeniable that the street price of heroin and cocaine is higher in Australia than in the US and UK.

That suggests that supply has not kept up with demand. There are two ways of viewing that fact.

Further, high profit margins may encourage more efficient suppliers. This was the destructive effect of alcohol prohibition in the US. this is an odd manifestation of moral hazard arising out of government interventions in markets.

if not “grace of god” then maybe “synchronicity“, as in the case of the cops unrelated operational interests in matthew chesher’s dealer coming to bear at wentworth park, on just the day & at precisely the time, the two arranged to meet there to illegally transact something. maybe it was human agency, but not human intention, that nabbed matthew chesher specifically that day during an election campaign.
a.v.

Does decriminalization deal with the apparent lure the “chasing” lifestyle seems to have? There is a domesticity in the idea of self aware responsible addicts quietly queuing for their daily fix that was not in evidence at my local pharmacy. What with the inept shoplifting, half arsed robberies, the threatening behaviours, it did try people’s patience. It seems that prescribed medication, for some, is not a pathway to a more engaged functional relationship with society, but just another free hit. Then on to do some robs, grabs, and cons to get some street drugs.

The argument for drug prohibition is exactly analogous to the argument for gun prohibition. Only more so, on account of the fact that guns at least have a potential worthy use, whilst addictive intoxicants are inherently vicious.

Particularly when one factors in the growth in the under-class, no prizes for guessing why guns and dope are the easiest short-cut to being top-dog.

The argument for drug prohibition is exactly analogous to the argument for gun prohibition. Only more so, on account of the fact that guns at least have a potential worthy use, whilst addictive intoxicants are inherently vicious.

Laughable. Guns in the right hands at the right moment have a worthy use. This is especially so in highly urbanised settings. Most of the time they don’t, and so most of the time most people shouldn’t have them. Even at those moments that are the exception, the marginal advantage can be lost. One recalls that incident in which the congresswoman from Arizona was shot recently. The confusion at the scene and the fact that multiple folks were armed nearly ensured that citizens trying to do the right thing might have shot innocent citizens also doing the right thing.

The chance that resort to mind-altering substances will lead to collateral damage to third parties is not negligible, but it is certainly more manageable because there is typically an absence of malice. It’s much easier to prevent a drug abuser from harming others than a spree killer with a machine pistol.

Also, as long as I’m responding TMFS is also wrong to say that drugs have no potential worthy use. Salving one’s pain, and feeling euphoria are axiomatically good uses. What is better than feeling good, for those who can’t feel good otherwise?

This discussion is (or ought to be) about how one can reconcile divergent claims to happiness. How can a community maximise the wellbeing and freedom of its members? To what extent, if at all, and under what circumstances, is coercion warranted?

drsusancalvin: I think that’s a fair point. There was no joy in the 05:30 start at the methadone clinic I once ran – just queue of misery. Street dealing out the front was common as was petty crime in the vicinity. One of our regulars wa a one man crime wave. Still, you have to wonder whether the criminal culture derives from he criminalized activity of heroin use and years of being in an out of court and gaol? Take the criminality out of it and all that is left is pretty boring domestic addiction. No glamour at all.

Illicit drugs typically make people feel good. They can reduce anxiety and encourage good feelings towards others. Many alleviate pain, because they are close analogues of the licit drugs that are prescribed for that purpose. Marijuana has been shown to have beneficial medical effects beyond those previously listed, specifically slowing tumour growth, acting as an antispasmodic, and reducing nausea. It helps glaucoma, MS, ADD, PMS and Tourette’s sufferers.

akn
An honest question.
In my experience with dealers and users( pot, ekies and ice mainly, not heroin) the standard action when busted and presented with forms asking “Aboriginal or non- Aboriginal ” is always tick Aboriginal, in the belief that they are likely to get free legal representation and/or a lenient sentence at least.
That behaviour, if as wide spread as i believe it to be, would skew the crime stats a great deal.

That’s a contentious claim, Jack. Sure, using them to control pests, hunt for food and euthanase sick or injured livestock is worthy, but the use to which I put most of mine (recreational target shooting) is actually frivolous.

f_n you’re deliberately missing my points. First off RBTs have nothing to do with the discussion, but standard drinks do. They are a form of education that came in the year I got my license and myself and people I know have been using them as an approximate (and inaccurate) guide to their BAC ever since.

Which to me indicates that people are capable of using information to make semi informed decisions.

Secondly comparing rural thailand or china to melbourne in the v early 90s is silly. The demographics are different for a start and people in Asia didn’t just come out of a decade where they grew up having “Just say no” rubbish rammed down their throats and reacted to it. Of the people I knew about 20 of 25 would probably never have gone on to use drugs IV if not for the availability of clean needles and swabs and water. Some of those people I convinced to take up that method of drug use myself, and I still regret tho it seemed ok at the time. There’s some anecdotal evidence for you.

That was an unexpected consequence of the govts policy – a policy which undoubtedly saved more lives throughout Australia inhibited the spread of HIV/AIDS throughout the country.

Which goes to show that policy can have unexpected/unforeseen outcomes that are less than ideal.

Funnily enough that brings us full circle back to prohibition.

And thirdly the failure of prohibition to prevent ODs or heroin use in the 90s or any other time for that matter. Even that seizure of 400kgs from a boat about 10 years ago had no effect on the market or the supply of heroin. However the decrease of production in Afghanistan during 2001 would have had an impact on the amount of heroin coming into Australia as that decrease did nothing to change demand, only supply – why sell the shit in Australia for a pittance (esp given exchange rates) when suddenly there are markets crying out for it in Europe?

The fact remains that since heroin was made illegal in the early 20th century the rate of OD and the power of organised crime connected to its supply has skyrocketed. Prohibition of its use has failed utterly.

Jarrah @ 101 re pot and tumor growth there is even a study from 2006 that shows smoking cannabis (on its own) has no increased risk of cancer. Thats a bit of a stretch imo but the study exists.

However the risk of cancer is no reason to leave cannabis simply decriminalised. There are more ways to consume cannabis than smoking it – the most obvious being eating it or inhaling vapour. Why penalise those that don’t smoke but want to consume the drug?

whilst addictive intoxicants are inherently vicious.

Oh yeah definitely (or not) – then again its always nice when Bill Hicks is right.

Once upon a time there was a genuine, living intellectual drug culture that provided a narrative, discourse, language and rationale for drug use. Collectively, they changed the world.

Those discourses — those communities — are now dead. No one with amy sense buys their projects (though their aesthetics are still interesting). Those who seek to become part of it today are naive nostalgics. The rest are what they have always been — sad losers.

[excessively long comment deleted - you have your own website, write it out there and give us a summary with a link ~ moderator]

The comments policy of this site gives the power of the moderator to determine acceptable comments and delete excessively long comments. So fair enough.

I do not have an up and running web site.

[Moderator note: so why do you keep linking to a website URL every time you post a comment? Fix that, it is totally under your control. Then we might no longer expect you to provide content there, although of course it takes all of ten minutes to set up a free blog on any one of several different services, so it's hardly an excuse anyway.]

I note that numerous comments on this post exceed my own comment length (446 words). [snip]

[Moderator note: fair point. However, the fact that those commentors who have been placed into automoderation due to past breaches of the LP comments policy are more prone to have this rule applied to them is just a facet of how some comments are flagged for our volunteer moderators to pay particular attention to. If the other commentors you note start to breach the comments policy in other ways, they too will be automoderated.]

akn, a famous researcher called Lee Robins did a lot of work with returning Vietnam vets that strongly suggested that criminality precedes drug addiction. Many American soldiers used heroin in Vietnam because alcohol was too hard to get, but they dried up instantly when they returned to the USA and could get alcohol again, but the ones who stuck to heroin were much more likely to have a history of what was then called “juvenile delinquency” before they entered the army (and consequently got access to heroin).

The idea that methadone is somehow worse than heroin for these people is really, really hard to square with their pre-methadone lifestyles.

Incidentally, I never used to be pro-prohibition. Even after years of working in centres that provided health care to IDUs, and seeing the train wreck heroin made of their lives, I still thought prohibition was worse. But my experience researching the consequences of the heroin shortage changed all that.

Jules, the fact that you introduced a few people to injecting doesn’t mean that NSP and govt policy caused it. Older users have been introducing younger users to injecting ever since injecting was possible. I gave you lots of other examples of the history of this process, not just in Thailand and China.

Furthermore, Afghan heroin has nothing to do with Australia – you have your history wrong in any case (heroin production increased after 2001). Australia’s heroin comes from SE Asia and were it to be replacing the pre-2001 collapse in Afghan stocks, we would expect to have seen it on the streets of Europe (it’s easily identifiably different to Afghan heroin). We didn’t, and this is not surprising: how do you think a group of heroin traffickers in Vietnam were going to suddenly make contacts in Afghanistan and shift their export business from Afghanistan through Tajikistan to Russia? And why would you think that would be a less risky business than simply trying harder to outwit Aussie customs?

RBT and BAC’s history is important to your point because you were trying to claim that education caused the reduction in road traffic fatalities due to drinking. It didn’t, and the evidence for this is obvious – standard drinks weren’t invented when it happened. The weaker point – that people are able to control their drinking and always get exactly the same level of effect – is patently obviously wrong. Or do you think all those people puking on the streets of a Friday night were really looking forward to doing that?

RBT and BAC’s history is important to your point because you were trying to claim that education caused the reduction in road traffic fatalities due to drinking.

I didn’t, and if it came across that way I obviously made my point badly. However it certainly made a difference to just about everyone I’ve known with a drivers license who drinks alcohol. That was the point of bringing it up. Obviously having some idea of what you drink and not lose your license makes it easier for people who don’t want to risk losing their license to drink responsibly.

Older users have been introducing younger users to injecting ever since injecting was possible.

I know, but you’re assuming I was older than my peers when I wasn’t.

Myself and a large percentage of IDUs I kneew over a period of 2 years, all the same age and roughly the same demographic, got into injecting amphetamines in the early 90s. One reason was the easy availability of clean gear. In fact it was the main reason since most of us wouldn’t have considered doing that without that access to that clean equipment.

No doubt if it was available many of us would just kept doing lines. I certainly would have.

Since then I’ve met quite a few people who have said similar things. So afaic the amphetamine injecting culture in Melbourne in the early 90s would not have developed as quickly and would have involved alot less people without easy access to clean injecting gear Possibly it wouldn’t have developed at all – that iv speed use would have remained a thing heroin users did as well. (BTW What other examples, besides saying “the USA”, did you give? maybe I missed that post.)

I want to make it clear I regret some of the decisions I made as a young man. Specifically introducing people to injecting speed, or convincing them it was better than having a line. There isn’t much to be said for speed use.

Australia’s heroin comes from SE Asia and were it to be replacing the pre-2001 collapse in Afghan stocks, we would expect to have seen it on the streets of Europe (it’s easily identifiably different to Afghan heroin). We didn’t,

Well I wasn’t there and neither were you. It stands to reason that the the drop in heroin production in Afghanistan had something to do with the Talibans 2000 decree banning opium production. And that other suppliers would be interested and capable of filling the vaccuum in supply.

Maybe some European junkies can tell us if they had different coloured drugs in the early 2000s.

I’m interested to know what happened in the way of increasing arrests or seizures of drugs during the heroin drought period that leads you to think prohibition worked. About 700 kg were seized in the lead up to the drought, but use in Australia would be probably more than 10 times that amount so I don’t see how prohibition could have worked.

Or caused the “heroin drought”.

Ruining one drug importation syndicate doesn’t do anything for stopping drug importation either as there are always another 20 groups vying to take the place of the syndicate thats just been busted.

A quick check indicates that there was a significant (greater than 50%) drop in SE Asian production between 96 ad 01 and that it was primarily due to droughts and flooding. So perhaps I was wrong about the drop in Afghan production affecting where SE Asian heroin went, but it also appears that leading up to the drought areas in eastern Asia and possibly Canada also increased their intake of SE Asian heroin. So really increasing demand from Europe isn’t necessary. It seems there was increasing demand elsewhere and a drop in production as well.

Finally it was about that time that crystal meth production increased and many of the people that were importing/exporting heroin into Australia suddenly got into the business of importing meth and fake ecstasy.

That makes sense as its cheaper and easier to produce those stimulants than it is to produce heroin – you don’t have to rely on the weather to guarantee ingredients for a start.

f-n: I’m familiar with Lee Robins work. He was an entrenched theorist of ‘deviance’ publishing, for example, ‘Deviant Children Grow Up’ (1966). The title will give you a hint as to what is wrong with this sort of thinking. The intellectual corrective to the entire deviance school of sociology is Colin Sumner’s 1994 ‘Sociology of Deviance: An Obituary’.

BTW: I didn’t suggest that methadone wasn’t an improvement on heroin in the current circumstances. I did suggest that the daily visit to a ‘done clinic was a miserable way to have your life structured. Some need it, some don’t.

Your moralistic sermonising on the success of prohibition simply ignores counter arguments and counter facts to which you simply do not respond. It is clear that you haven’t bothered to read the report that initiated this thread because you don’t address any of the issues it raises. You do harp on about the evils of heroin maintaining that the only way to prevent harm to people from heroin is to stop them taking it. All the while you steadfastly ignore any evidence to the contrary and refuse to countenance the idea that the war on drug users has serious, negative consequences of its own.

akn, you haven’t presented any counter-arguments, just accusations of moralism. And Lee Robins is a woman, by the way.

It appears that you value civil liberties over good health. I presume, then, that you are opposed to any form of taxpayer funded universal health care?

Jules, Afghan heroin isn’t just a different colour to SE Asian heroin. It requires a different solvent. They are thoroughly different substances, and part of the reason that substances get injected rather than imbibed in Australia is that historically Australia’s drug culture has developed around easily injectable heroin. Once again, the notion that some Vietnamese heroin rackets could suddenly switch their business model to drug routes on the other side of Asia is ludicrous. They might have switched to China (whose market has been growing rapidly) but we have no evidence for that.

The NDLERF reports I mentioned earlier include the results of extensive research into Australia’s activities overseas, interviews with key figures in customs, and reviews of confidential intelligence reports about the drug trade. They don’t just construct a theory out of a drop in ODs and a date. They also confirm another important point that is clear throughout central Asia, South East Asia and China: the single biggest determinant of the growth of drug abuse is being on a drug trafficking route. Australia is the terminus of such a route because we are rich and we used to have poor defenses against importation. When we upped those defenses, SE Asian drug dealers gave up on us, either switching to other markets or moving their product to other countries.

I’m sympathetic to the argument that drug dealers and users switched to speed but there is no evidence of this. Amphetamines were growing as the drug of choice amongst NSP attendees long before the shortage (since about 1997), and the stats on amphetamine offences and amphetamine-related hospitalization showed no change in the aftermath of the shortage. It’s likely that the amphetamine market is dominated by homegrown crime syndicates, which were not affected by the success of customs against international groups. The idea of substitution is an appealing one but there is no evidence for it. Amphetamine injection grew in Australia because Australia has a long-standing history of non-medical injection of drugs, both pharmaceutical (since the 50s) and recreational (since the 60s). This is why prevalence of HCV was above 70% in the 1970s, long before NSP, and why amphetamine injection was growing as a phenomenon in the mid-90s. Nothing to do with NSP and nothing to do with drug substitution after the shortage.

akn, that article you linked to is ridiculous. Brazil is not Australia, its problems are not our problems, and arguments about Australia’s drug laws based on Brazil’s experience are just pointless. And why are you referencing an article that discusses America’s drug war extensively? I think it’s because you – like a lot of people in Australia who do this – think that the USA and Australia have similar drug policies. We don’t, and the US war on drugs is an abhorrent system of oppression that does not in any way resemble that in Australia.

As I said above, we need to drop the USA from the debate, and talk instead about what is actually happening, and what can actually be done, in countries with non-insane political systems. Don’t use the US’s cock-ups as a basis for discussion of a completely unrelated system.

Why would’ve I thought that contributing to this thread here would’ve been a waste of time as it would likely degenerate to one (all seeing all knowing) commentor versus anyone who didn’t agree? What’s the bet they will always want to have the last word on any thread on this topic too?

Why even bother posting on the topic here when everytime I’ve seen the topic arise one single commentor disabuses almost everyone else and repeatedly dominates the discussion?

There are several threads at ‘The Conversation’ at the moment that raise general problems with the war on drug users all of which derive from the dominance of US puritanism in pursuing same at both a national and international level. If you only read one then that’s up to you. Don’t expect me to spoon feed you.

If you can’t discern that countries like Brazil and Australia and others of a broadly democratic nature might be able to inform each other and learn from each other in relation to social policies around common social problems then this is due to your narrowly technocratic intellectual training. The drug use issue engages with matters of governance that go well beyond your expertise in public health. In other words the world is a bigger and more complex arena than your agar plate.

Prohibition is not control; it is the lack of control. The only people who benefit from prohibtion are crooked coppers, of which there remain no shortage in NSW, and their mates in organised crime.

BTW: deviance theory in sociology was a vicious attack on all sorts of minorities by which difference from established ‘social norms’, as defined by professional middle class lab coated normalisers, was pathologised. It’s dead and so are all of its arguments – every Sydney Mardi Gras parade is a danced onn the grave of deviance theory.

The inescapable fact that you cannot address is that every incident of recreational drug use is self administered including, of course, the legal drugs – tobacco, coffee, tea and alcohol. You fail to address the matter of agency and choice exercised by drug users in a liberal democratic society. This raises serious concerns with your approach to our democracy. We are entitled to live our lives by our own lights, it seems, but only so far as we adhere to the authorised range of choices you and your ilk deem acceptable.

Watershed summit will admit that prohibition has failed, and call for more nuanced and liberalised tactics

Otto Pérez Molina, the president of Guatemala, who as former head of his country’s military intelligence service experienced the power of drug cartels at close hand, is pushing his fellow Latin American leaders to use the summit to endorse a new regional security plan that would see an end to prohibition. In the Observer, Pérez Molina writes: “The prohibition paradigm that inspires mainstream global drug policy today is based on a false premise: that global drug markets can be eradicated.”

{…}

He insists, however, that prohibition has failed and an alternative system must be found. “Our proposal as the Guatemalan government is to abandon any ideological consideration regarding drug policy (whether prohibition or liberalisation) and to foster a global intergovernmental dialogue based on a realistic approach to drug regulation. Drug consumption, production and trafficking should be subject to global regulations, which means that drug consumption and production should be legalised, but within certain limits and conditions.” {my emphasis: FB}

{…}

Last year Juan Manuel Santos, Colombia’s president, told the Observer that if legalising drugs curtailed the power of organised criminal gangs who had thrived during prohibition, “and the world thinks that’s the solution, I will welcome it”. {my emphasis: FB}

{…}

Fernando Henrique Cardoso, former president of Brazil and chairman of the global commission on drug policy, has said it is time for “an open debate on more humane and efficient drug policies”, a view shared by George Shultz, the former US secretary of state, and former president Jimmy Carter.

f_n for prohibition to have worked there has to some evidence of it in the form of an increase in seizures to a point that would actually influence the market and enough arrests to influence the actual distribution networks.

You are taking two things – a decrease in the OD rate and the “tough on drugs” strategy and linking them despite a lack of an actual mechanism to show how the first was caused by the second.

The heroin market of the late 1990s was of an unprecedented scale. However the market had a low profit margin, with high heroin purity, and low cost. Drug law enforcement received comparatively little Federal funding at the time.

It is likely that the heroin shortage was due to a combination of factors. The increased funding provided to the Australian Federal Police and the Australian Customs Service as part of the National Drug Strategy probably made the risks of importation greater. This occurred at a time of low profitability and reduced reliability of key suppliers of heroin to Australia. All of these factors probably reduced the attractiveness of Australia as a destination for heroin trafficking.

The heroin shortage was probably caused by changes in the heroin supply to Australia related to drug law enforcement and was most likely as a result of actions aimed at the very high levels of drug trafficking.

Note the last paragraph kind of contradicts the second one by claiming that the actions of law enforcement against high level drug traffickers was the likely cause. To me that seems inconsistent, in fact it seems as if its tacked on the end specifically to reinforce the need for further funding of law enforcement.

Also if you can be bothered you can go through the NDLERF reports on amphetamine use in Australia which do indicate an increase in use throughout the 90s and in the late 90s and early 00s an increase in the importation of ice/crystal meth from SE Asia.

So AFAICS saying prohibition “worked” during the heroin drought is more of an opinion than an evidence based proposal.

Drug liberalisers have lost their moral compass and they don’t even know it. The routine administration of addictive intoxicants as a life-style supplement (or substitute in some pathological cases) is morally wrong in itself, and not just in its social consequences.

Most public policy discussion simply assumes utilitarian liberalism as a political ethic. The limiting cases are children, criminals and the insane. Drug addicts, for all intents and purposes, fall under the “insane” heading. So, in this case, utilitarian liberalism suffers from failure to launch on its own grounds.

But liberal utilitarianism itself is questionable as a basic morality because it focuses on consequential, rather than fundamental, aspects of morality. Taking a lead from Kant I suggest the following ontological conditions for a moral act:

This is apart from the obviously destructive impact addictive drugs have on physiological health. Self-harm is still harm, after all.

But, in the media-academia debate on drug policy, one finds nary a mention of the basics of morality. Like fish in water they are completely unaware of their (amoral) philosophical environment.

Fortunately the common people, so often derided or ignored by po-mo liberals, still cling to their antiquated moral traditions, of the tacit and “it goes without saying” type. Thank God that democracy gives the populus the final say.

It turns out that religion and the wisdom of our elders are a more reliable guide through this mine field than high-falutin’ philosophies. But we wouldn’t want to wander back down that path, do we? That would be uncool, the one and only deadly sin that po-mo liberals most dread being accused of.

The routine administration of addictive intoxicants as a life-style supplement (or substitute in some pathological cases) is morally wrong in itself, and not just in its social consequences.The routine administration of addictive intoxicants as a life-style supplement (or substitute in some pathological cases) is morally wrong in itself, and not just in its social consequences.

Jeez Jack, are you arguing for the banning of alcohol on moral grounds?

Jack, apart from occasional cannabis use, I’m also a routine meditator in the Theravaden tradition. It is profoundly mind altering. Does this make it undesireable because, following your belief, anything that alters mind states necessarily ‘undermines consciousness’. My experience is that it sharpens and refines consciousness. I think when it comes to the matter of consiousness you may not know what you are talking about.

Fortunately the common people, so often derided or ignored by po-mo liberals, still cling to their antiquated moral traditions…

…by voting with their feet and using mind altering substances left, right and centre? Or are you talking about extremely uncommon people, like Mormons? Or are you simply drunk, and have no idea what you’re saying?

“It turns out that religion and the wisdom of our elders are a more reliable guide through this mine field than high-falutin’ philosophies.”

Ah yes, because mind-altering substances have never been involved in religious observances. Christ’s blood was red cordial, right? [Actually, communion wine is almost as horrifyingly cloying and sweet, now I think about it].

Poor Jack. The stars of the Strocchi-verse wheel about you, tugging you hither and yon on your Quixotic tasks, yet you still feel compelled to pronounce on the real world; whose past, present and future elude you completely.

I had some acid a couple of weeks ago. First time in a couple of years. Tightened my game right up. You should try it, Jack. It’s not addictive, and if anything it’s an antidote to the “solipsistic self-centredness” that seems so to plague you.

“I had some acid a couple of weeks ago. First time in a couple of years. Tightened my game right up.”

I’ve found the same thing true of psylocibin mushrooms FDB. I only have them every few years but have found they are like a mental tune up and oil change.

Can’t stand acid though, after a few hours i just want it to stop. I always feel like i’m hanging on to sanity by my finger nails for the last half of the trip! Shrooms on the other hand are nice and friendly, but each to their own.

“It turns out that religion and the wisdom of our elders are a more reliable guide through this mine field than high-falutin’ philosophies.”

Too true Jack. Pretty much every religion in every culture, going back to prehistory, have used drugs, fasting, sensory deprivation and meditation to alter their perceptions and “undermine” their consciousness. Who are we to spurn the wisdom of our elders?

then there was flin flon in north manitoba & its gov’t pot-lined “disused” mine shaft. seems the gov’t (dept of health?) grew pot there “for evaluation” for medicinal purposes. gov’t grew & grew, but tabling of the final recommendation was delayed & delayed. would the state get into the business of growing pot, in order to supply its citizen’s bona fide medical needs though medicare? or not. the delay led to “hitzig v canada” in 2003:- http://en.wikipedia.org/wiki/Hitzig_v._Canada . hitzig & associates had recognised medical needs, gov’t had the medical substance needed, and gov’t indecision was impeding their rightful legal access under the charter of rights. they claimed that access to cannabis medicine was illusory & forced people to look to the black market for their legal medication. judge agreed that this situation violated the rights of the applicants as set out by the Canadian charter of rights & freedoms (1982) & gave gov’t 6 months to fix it. gov’t was promptd to announce that health canada would soon begin distribution of marijuana grown under contract to prairie plant systems in flin flon, manitoba. (paraphrased from from wiki)

Strocchi is the one framing the “drug debate” in puritanical drug war terms. I might disagree with f_n over the effectiveness of prohibition but at least we have our own semi rational motives for our positions.

The “moralistic” basis of prohibition is completely fucked up.

But its always the final fallback position of the prohibitionists. “God said no so lets keep giving cocaine money to criminals…” Its an irrational argument so it makes it hard to mount rational arguments against it. They don’t seem able to compete with the power of God is watching you and hates laughter/every time you have a good time baby Jesus dies a little or whatever the fuck they are saying.

I really don’t think the “moral evil” associated with ending the war on drugs needs to be considered in this debate cos the alleged “moral good” is clearly responsible for a policy that has failed.

I dunno if anyone remembers when Christopher Pyne said that while pill testing might save lives it should remain illegal and that it “sent the wrong message” on JJJs Hack program years ago. So in pursuit of some alleged moral purity Pyne was basically saying that its worth having young kids die from the wrong party drugs. I presume that somehow those deaths would become moral, contributing to the moral fibre of our country and that would be a real comfort to the families in their grief… Or maybe Pyne is just a slimy piece of shit.

The use of “morality’ to justify the war on drugs appears to lead to the immoral position that anything that might save lives but “send the wrong message” should be resisted or rejected or arrested. The association of morality with the war on drugs needs to be dropped into the dustbin, where it belongs.

Well, at least Stocchi has courage enough in his delusions to come out and say what those who hide behind a public health smoke screen are too timid to say. As to all drug users paying the full health dollar costs of their indulgences – that’s the way to go but let’s start with those injured in motor vehicle accidents. End CTP insurance!

Drug liberalisers have lost their moral compass and they don’t even know it. The routine administration of addictive intoxicants as a life-style supplement (or substitute in some pathological cases) is morally wrong in itself, and not just in its social consequences.

Let’s investigate the corollary of Strocchers’ strictures.

Any program of prohibition that allows the trafficking of any quantity of prohibited substance is a failure. There is no upper limit to the expenditure of blood and treasure in the cause of ultimate victory in the War on Drugs.

Any program of prohibition that allows the trafficking of any quantity of prohibited substance is a failure. There is no upper limit to the expenditure of blood and treasure in the cause of ultimate victory in the War on Drugs

.

<moralpanic>
That’s true. Of course, if you simply executed anyone found to show traces of the metabolites of any illicit or illegal drug in their bodies you could make major inroads into “the drug problem”. Hardly anyone would overdose or harm themselves because the state would do it for them.

Of course you’d have to extend that to people taking prescription drugs contrary to (or without) prescription, just to be consistent. Likewise alcohol and tobacco both of which are at least as lethal not only to users but third parties. Sadly, that would mean executing unfortunate passive smokers including children but really, can any price be too high when we are dealing with the scourge of drugs? It’s an existential evil after all. All those soiled temples stain humanity.

Jeez Jack, are you arguing for the banning of alcohol on moral grounds.

Only if the taking of addictive intoxicants reaches a level where it undermines the ontology of moral activity. ie cognition, affection and volition. I don’t have a problem with society tolerating mild and discretionary intoxication or turning a blind eye to occasional soft drug usage.

If alcohol or hard drug usage so poisons your blood it undermines your consciousness, if it causes you to abandon you social obligations and if you are so addicted to it that you can’t stop: then, yes, I’d ban it.

Although selectively, not generally, if that is at all possible.

This is precisely what has happened in the NT Intervention. I don’t have a problem extending the Intervention to white fellas who need supervision.

The notion of banning alcohol on moral grounds is not hardly novel. The Temperance Movement was one of the most powerful political movements of the 19thC. Amongst their many worthy achievements was the construction of many magnificent monuments (so-called “coffee palaces”) all over Melbourne and the Anglosphere. The Windsor Hotel was one such.

More generally the progress of pharmacogenomics and other neruroscientifc technologies will make current intoxicants seem like children’s toys. Brave New World is not that far off and it would be a good idea to arrest the slide into solispsitic hedonism rather than go full speed ahead.

They’re not all addictive. Of the ones that are, there’s a great variety in their addictiveness – some are about as addictive as Tim Tams. Does the consumption of the brain/mood-altering, body-chemistry-altering substance ‘sugar’ get a free pass from you?

“1. mind-altering: undermines consciousness”

Or expands it. Or changes it for the better, or in ways that defy classification. Learning a very important fact, having an epiphany, or having a profound experience (like watching your child being born) are all mind-altering… and life-altering. None of them ‘undermine’ consciousness.

“3. solipsistic self-centredness: dissipates good will”

You’ve obviously never ingested MDMA. One of its prominent effects is to generate strong other-regarding feelings, good will, and a sense of connectivity. This is why it’s used therapeutically.

I’m sorry, Jack, but you really have no idea what you’re talking about.

…by voting with their feet and using mind altering substances left, right and centre? Or are you talking about extremely uncommon people, like Mormons? I had some acid a couple of weeks ago.

The fraction of the (non-indigenous) population who indulge in routine administration of (illicit) addictive intoxicants (ie drug addicts) is currently, thanks to drug prohibition, statistically insignificant. According to Greg Pike between one and five per cent of the population are chronically (daily) addicted to the Big Four (cannabis, heroin, cocaine and meta-amphetamines). See the AIHW report for the breakdown.

For populations where addictive drug usage was effectively liberalised see the 19thC China, and inner-urban areas of US cities between 1965-95 and the North West frontier of Pakistan, right now. If you dare.

Heavy drug usage seems to have been a Baby Boomer thing, peaking in the nineties and been in decline ever since. Younger people tend to shy away from hard drugs, associating it with losers (stoners, derros, public housing clients).

You should stop dropping acid, its kind of pathetic at your age. Maybe take a leaf out of the Mormons book, who don’t seem to be doing too badly these days.

I’ve tried pretty much everything, but your get-out-of-jail-free-for-some-reason drug alcohol is the only one causing me any difficulties vis-a-vis addiction and health problems – your finger-waggling disapproval notwithstanding of course.

But considering your breathtaking ignorance of the effects of drugs, the prevalence of drug-taking and pretty much everything else about the real world of today as it pertains to drugs and everything else besides, you’ll forgive me if I file your advice under ‘M’ for ‘meh’.

Answer me this though – if the prevalence of genuine addicts (of the substances you don’t like) is as low as you say, why should occasional users like me be considered criminals? Do you consider me a criminal for taking a tab of acid (one of a sheet obtained from a long-departed friend, but thankfully still bracingly potent, but that’s another story), and giving a few away to some like-minded friends at a music festival?

What actually IS the moral basis for your position if so, bearing in mind Jarrah’s, my own, and others’ quite simple rebuttals of the claptrap you originally sailed in here with?

If alcohol or hard drug usage so poisons your blood it undermines your consciousness, if it causes you to abandon you social obligations and if you are so addicted to it that you can’t stop: then, yes, I’d ban it.

So what if it poisons Ralph’s precious bodily fluids so much that he loses all cognition and engages in behaviour that undermines his social obligations at the same time he simply can’t stop and drinks till he passes out from an undermined consciousness, all the time, but it doesn’t do the same thing to me?

What if in fact it makes me giggle a little smile a bit and enjoy the walk home with a slightly warm feeling and a sense of oneness with things and a feeling of being at peace with myself and everything else. Once in while. Cos I don’t drink that much.